tbuckley/cabot-search huggingface dataset:
The Last Day
Authors: William Lynes
Journal: Annals of Internal Medicine (2016)

On Being a Doctor3 May 2016The Last DayWilliam Lynes, MDWilliam Lynes, MDFrom Temecula, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2341 Audio Reading - “The Last Day” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Day," by W. Lynes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The room was cold and dark as I entered my office that last day. My diploma shone as a damaged image as I pondered the tragic plan, one of a burnt-out physician who could not practice anymore. I loathed that likeness; pathetic, weak, a failure at medicine, my lifelong goal. I had a family to take care of and a loving wife, but I was incapacitated and paralyzed with fear.Twenty-four hours later, miraculously I was alive, blood covering the floor of my office from the grim sacrifice. My choice to die at my own hands had failed. I informed ... Author, Article, and Disclosure InformationAffiliations: From Temecula, California.Corresponding Author: William Lynes, MD; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “The Last Day” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Day," by W. Lynes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 May 2016Volume 164, Issue 9Page: 631KeywordsAlcoholicsAnxietyEmotionsIntensive care unitsShockSuicideSurgeryThoraxTracheostomyWeight loss ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
COTRANS Students
Authors: Carl B. Lauter
Journal: JAMA (1979)

<h3>To the Editor.—</h3> I want to comment briefly on the article by Stimmel and associates (241:139, 1979) involving the clinical performance and specialty choice of COTRANS students. This article is of extreme interest to those of us involved in postgraduate and undergraduate medical education. To my knowledge, it, along with what has to be considered its sister article (by Stimmel and Smith<sup>1</sup>), stand as the only articles in the literature that shed some light on this type of problem. These two articles give a large amount of information to program directors and deans. The one question that comes to mind, however, particularly in the article of Stimmel et al inThe Journalis the location of the medical school from which the COTRANS students originated. I think it would be extremely useful to know how students from Asia, Africa, Europe, South America, and other parts of Latin America fare
Malaises des Aviateurs.
Journal: JAMA (1923)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Theoretische und klinische Pharmakologie: Ein Lehrbuch für Studierende und Ärzte.
Journal: JAMA (1933)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Poliovirus in the Upper Respiratory Tract of Household Contacts
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Predicting the outcome of salvage radiotherapy for recurrent prostate cancer after radical prostatectomy
Authors: A. J. Stephenson, A. Pollack, M. W. Kattan, P. T. Scardino
Journal: Journal of Clinical Oncology (2006)

4514 Background: Salvage radiotherapy may potentially cure patients with recurrent prostate cancer after radical prostatectomy (RP). However, the outcome is highly dependent on patient selection factors and current diagnostic modalities for locally recurrent prostate lack acceptable sensitivity and specificity. We developed a model to predict the likelihood of a durable response to salvage radiotherapy for patients with post-RP biochemical recurrence (BCR). Methods: Using multivariable Cox proportional hazards regression analysis, we modeled the clinical data for 1540 patients who received salvage radiotherapy at 1 of 17 North American tertiary referral centers for post-RP BCR. The primary endpoint was disease progression after salvage radiotherapy, defined as a serum prostate-specific antigen (PSA) value ≥ 0.2 ng/mL followed by another increase, initiation of systemic therapy, or clinical recurrence. The median follow-up was 53 months. Results: Disease progression was observed in 866 patients and the 5- and 10-year progression-free probability was 38% (95% CI, 35–40) and 19% (95% CI, 15–23), respectively. Significant variables in the nomogram were: pre-radiotherapy PSA (P &lt; .001), RP Gleason score (P &lt; .001), neoadjuvant androgen-deprivation therapy (P&lt; .001), negative surgical margins (P &lt; .004), PSA at BCR (P = .011), PSADT (P = .029), and regional lymph node metastasis (P = .034). The nomogram was accurate and discriminating with a concordance index of 0.68. Published models predicting the probability of metastasis progression or PCSM for BCR patients based on disease-free interval, prostatectomy Gleason score, and/or PSA doubling time discriminated poorly for a durable response to salvage radiotherapy among patients in our cohort (concordance index, 0.56–0.61). Conclusions: A nomogram has been developed that predicts the 5-year progression-free probability after salvage radiotherapy for men with post-RP BCR. This represents the first model to predict the outcome of salvage therapy for BCR and is useful for quantifying the anticipated benefit of salvage radiotherapy for prostate cancer recurrence. Published predictive models for metastasis progression or PCSM are of limited clinical utility in selecting patients for salvage radiotherapy. No significant financial relationships to disclose.
HIATUS HERNIA
Authors: Irving B. Brick
Journal: JAMA (1952)

<h3>To the Editor:—</h3> In the article "The Gastrointestinal Tract in the Aged" by Sidney A. Portis and Joseph C. King, which was published in the March 29, 1952, issue ofThe Journal, there is an error in the use of a report written by me. In the paragraph "Examination of Esophagus" it is stated "There were 10 (7.5%) with hiatus hernia—a finding which contrasts with that of Brick,<sup>27</sup>who reported that 76.6% of his patients between 50 and 80 had hiatus hernia." The exact article of mine which was used is not given, as references were omitted, but my data appeared in three articles:<i>Mississippi Valley Medical Journal</i>(<b>71</b>:2 [Jan.] 1949),<i>Archives of Surgery</i>(<b>58</b>:419 [April] 1949), and<i>Archives of Surgery</i>(<b>60</b>:1045 [June] 1950). In those articles it is stated that of the 308 patients with hiatus hernia, 76.61% were between the ages of 50 and
Update from the Hill: Budget Battle
Journal: Cancer Discovery (2011)

Addressing the cancer community at a town hall meeting in January 2011, Harold Varmus revealed that one thing he never anticipated the previous summer when he took the reins of the National Cancer Institute (NCI) was the dire financial circumstances NCI and the NIH are now facing.At a time when the science behind cancer treatment and prevention is accelerating, budgetary disputes in Washington, DC, are forcing him to cut back on key programs and research grants that could yield innovative and potentially game-changing discoveries.Congressional budget battles are nothing new to Varmus, who served as NIH director during the Clinton administration, but the
Cancer in elderly patients (CEP) in Tunisia: Retrospective study about 243 patients collected from 2002 to 2007.
Authors: Hammouda Boussen, Mohamed Malek Ayadi, Sonia Ben Nasr, Soumaya Labidi, Mehdi Afrit
Journal: Journal of Clinical Oncology (2013)

e20721 Background: To report the epidemiologic, clinical, extension, treatment and results of CEP in a Tunisian population from a department of medical oncology. Methods: We collected retrospectively cases of CEP (&gt; 70 years) within a cohort treated in a medical oncology department in Tunisia. We analyzed the following data : age, sex, delay to diagnosis(DD), site, histologic type, stage, co-morbidities, treatment and evolution. Results: These CEP collected from 2002 to 2007 represented 16.7% of the 1507 patients treated for cancer during this period. Mean age was 77.7+/- 4.2 years(70 to 86), SR 0.93 and delay to diagnosis 7.8+/6 5,28 months(1 to 48). Lung cancer (49 cases), digestive (46 cases) and Breast cancer (29 cases) represented the most frequent anatomic sites and patients presented co-morbidities in 75 cases. 11 patients (4.5%) developed metachronous second cancers and 40 pts (16.4%) have initial metastases at diagnosis. Treatment included CT in 148 pts (61.3%), S in 85 pts (34%) and RT in 40 pts (17%). Median survival was 24 months for the whole population. Conclusions: CEP represented more than 15% of patients treated for cancer in a Tunisian serie, this age group representing presently around 6% of the Tunisian population where aging modified in the last 20 years the ages pyramid aspect. CEP are characterized by late diagnosis/consultation, frequent co-morbidities, locally advanced and/or metastatic cases and probably less aggressive treatment compared to younger patients.
His bundle ectopic beats. His bundle electrocardiographic study
Authors: Z. Abedin
Journal: JAMA (1974)

Atrial pacing, and His bundle electrograms were recorded in a 62-year-old man with sinus bradycardia and a complex junctional arrhythmia. The arrhythmia was shown to be due to His bundle extrasystoles. The recognition of main-stem extrasystoles, based on analysis of surface electrocardiogram may not be possible, and His bundle electrocardiographic studies are necessary for the precise diagnosis of His bundle extrasystoles.
Neurogastroenterology/Motility posters 299-312
Authors: S Parry, J Barton, M Welfare, I Mohammed, L Cherkas, S Riley, T Spector, N Trudgill, S Lal, J Mclaughlin, G Giampaolo, G Dockray, A Varro, D Thompson, J Jones, D Kendall, P Millns, C Hawkey, S Dunlop, D Jenkins, R Spiller, L Gregory, L Yaguez, S Coen, E Amaro, S Smale, A Hobson, S Williams, Q Aziz, V Chudleigh, E Brennan, S Tarry, S Myers, S Lewis, G Smith, K Palmer
Journal: Gut (2002)

Introduction: Previous studies, many uncontrolled, suggest 4 to 32% of people develop irritable bowel syndrome (IBS) after ID.Little information is available on the development of other FGIDs after ID.Aim: To determine if patients with stool culture confirmed bacterial diarrhoea were more likely to develop gut symptoms consistent with a diagnosis of IBS, functional dyspepsia or functional diarrhoea at 3 and 6 month follow up compared with community controls.Methods: A prospective community-based case-control study over one year.Subjects with stool positive bacterial infectious diarrhoea and control subjects from the same primary care practice were invited to participate.The presence or not of IBS, functional dyspepsia or functional diarrhoea was diagnosed at the start and at follow up using self-complete Rome II modular questionnaires.The diagnosis of a baseline FGID excluded subjects from continuing.There were 128 cases and 219 community controls eligible and who consented to participate.Results: At follow up there was a higher incidence of FGIDs in the cases compared with controls, mainly due to a higher incidence of IBS (see table ).There was no difference in the incidence of functional dyspepsia between cases and controls.Conclusions: IBS and functional diarrhoea is diagnosed more frequently in people at three and six-month follow up after an episode of stool positive bacterial diarrhoea compared with community controls despite careful exclusion of people with pre-existing FGIDS and adds further support for the concept of post-infectious IBS.
The Brain as an Organ: Its Postmortem Study and Interpretation
Journal: JAMA (1935)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Homocystinuria
Authors: Esly S. Caldwell
Journal: JAMA (1971)

<h3>To the Editor.—</h3> The unusual cases of myocardial infarction in young women recently described by Brill et al (<b>217</b>:1345-1348, 1971) suggest homocystinuria. Arterial and venous thrombosis, mental retardation, osteoporosis, ectopic lentis, cutaneous flushing, dolichostenomelia, scoliosis, and high arched palate are often seen, but none of these are invariably present. The article did not mention any of these common characteristics but several could be easily overlooked. The presence of homocystine in the urine is pathognomonic. Most clinical labs can perform the cyanide-nitro-prusside test<sup>1</sup>and it is certainly warranted in the surviving case. However, urine chromatographic examination would be more specific. Other factors favoring this diagnosis are (1) the occurrence in siblings suggesting a hereditary pattern, (2) no discernible common predisposing factors favoring the occurrence of arterial occlusion, and (3) compatible abnormalities. Diet<sup>2</sup>and pyridoxine<sup>3</sup>have been reported to be of value. A family study may discover other
Prognostic value of alpha-fetoprotein in patients achieving complete response to transarterial chemoembolisation for hepatocellular carcinoma
Authors: Jae Seung Lee, Wonseok Kang, Dong Hyun Sinn, Moon Seok Choi, Geum-Yon Gwak, Yong Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Hwi Young Kim, Tae Hun Kim, Kwon Yoo, Yeonjung Ha, Young Eun Chon, Mi Na Kim, Jooho Lee, Seong Gyu Hwang, Soon Sun Kim, Hyo Jung Cho, Jae Youn Cheong, Sung Won Cho, Seung Ha Park, Nae-Yun Heo, Young Mi Hong, Ki Tae Yoon, Mong Cho, Jung Gil Park, Min Kyu Kang, Soo Young Park, Young Oh Kweon, Won Young Tak, Se Young Jang, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim
Journal: Journal of Hepatology (2020)
"OPEN" AND UNWHOLESOME FEBRUARY.
Journal: JAMA (1892)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Treatment decision making in metastatic prostate cancer (mPC).
Authors: Alicia K. Morgans, Angela Fought, Benjamin Lee, David James VanderWeele, Maha H. A. Hussain, Kelvin A. Moses, David F. Penson
Journal: Journal of Clinical Oncology (2020)

224 Background: Multiple treatments exist for mPC, and optimal treatment choice is not defined. Shared decision making (SDM) in which physicians communicate treatment purpose, risks, and benefits, and patients (pts) communicate values/preferences can be used to determine treatment. SDM is associated with superior health outcomes in non-cancer populations, but whether it is used in mPC is unknown. We assessed mPC pt and caregiver perceptions of decision locus of control (DLOC) (SDM vs physician (PD) or pt (PtD) directed decisions), and characteristics associated with DLOC. Methods: Between 12/16 and 11/17, mPC patients and caregivers completed surveys of decision making practices after a clinical encounter in which a decision occurred. To evaluate the relationship between pt perception of DLOC type and categorical variables we used Fisher’s exact test, and Kruskal-Wallis was used to evaluate the relationship between DLOC and age. Results: 50 pt/caregivers participated, with median pt age of 72 yo. Most pts were Caucasian (96%), married (90%), and reported good health or better (18% excellent, 58% good, 24% fair). 66% of pts reported SDM, 10% reported PD only, 12% reported PD considering patient’s preferences, and 12% reported PtD considering physician’s recommendation. Caregivers reported numerically lower rates of SDM (56%), PD only (6%), and PD considering patient’s preferences (8%), but greater PtD considering physician’s recommendation (30%), (p=0.28). Neither reported PtD without considering physician recommendations. There was no association between pt DLCO and age (p=0.70) or clinician type, (p=0.13). All pts reporting PtD considering physician’s recommendation saw medical oncologists rather than urologists. Conclusions: Both pts and caregivers perceived a majority of decisions as SDM, indicating a high level of patient engagement in mPC decision making, and clinician type and patient age were not associated with pt reported DLOC. Pts seen by medical oncology in this cohort reported directing treatment choice when considering physician’s recommendation. Efforts to assess and support decision making in more diverse patient populations and explore the association between SDM, pt satisfaction and quality of life are underway.
French-English Science Dictionary for Students in Agricultural, Biological and Physical Sciences
Journal: JAMA (1941)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal